Discuss about the Implementation of WHO Multimodal Strategy.
Hand Hygiene can be described as the five key initiatives those have been set for the safety of the patients by the world Alliance for patients. According to the World Health Organization “The goal of Clean Care is Safer Care is to ensure that infection control is acknowledged universally as a solid and essential basis towards patient safety and supports the reduction of Healthcare-Associated Infections (HAI) and their consequences” (WHO, 2017). There are various types of infection those are capable of encountering the patients and could be stopped by effective compliance of Hand Hygiene (HH) within the medical care premises. In manner to make it happen, proper education, guidance, training, methodologies are the crucial objectives. This report presents critical evaluation of ten articles presented on the hand hygiene compliance by different areas and putting emphasis on different sectors of the hand hygiene compliance. Following report presents a thorough research on ten papers proposed on the relative topic related to the compliance of hand hygiene within intensive health care facilities. The articles were chosen in manner that second article eliminates the limitations of the first article and add additional information related to the processes that could help in enhancing the efficiency of the hand hygiene compliance. Regarding all the facts and aspects presented by all the authors, it can be reported that proper education and training are the possible keys for the compliance of hand hygiene within the intensive health care facilities with complete efficiency.
Many articles were popped up while searching ‘hand hygiene compliance’ on Google Scholar and IEEE Explorer websites. There were hundreds of articles related to the hand hygiene among which fifteen articles have been chosen for this research paper. Among them ten articles those were strongly related to the topic were chosen and based on that critical evaluation on those papers has been proposed in this paper.
The very first article stated about the RFID based monitoring station on the hand hygiene compliance which could be helpful for maintaining and monitoring healthy environment. In this paper Meydanci et al. (2013) introduced the beneficial aspects related to the Hand Hygiene (HH) and how the system could be implemented to the current monitoring devices and systems using badges or wrist bands in manner to control the users. This paper presents a thorough research on the RF-ID based electronic devises those are user friendly in nature and could be implemented within the existing system of the medicals in manner to enhance the monitoring capabilities. The system that has been introduced in this paper introduces a wearable, wristband with passive RF-ID technology, with software that could be helpful in measuring the rate of the Hand Hygiene compliance and a wall mounted dispenser (Haque et al. 2017). Based on the research made in the paper, it can be stated that technologies like RF-ID implemented within the wristbands could be helpful in ensuring the hand hygiene compliance with higher efficiency than any other monitoring system. There were certain limitations of the technology, which includes that system is incapable of detecting whether the caregiver needs to perform the HH procedure or not.
Other article was presented by Johnson, Tsouri & Walsh (2012) this was an upgrade of the research made in the first paper that ensures measuring of the compliance of HH with RF-ID technology along with the finite state machines. The paper presented a prototype and a noble method that have been developed in manner to measure the health hygiene compliance within the medical hospitals. The technology that is being proposed in this paper is based on alliance framework between the RGHS (Rochester General Health System) and RIT (Rochester Institute of Technology) named under RIT-RGHS Alliance. This technology can be stated as the upgrade version of the technology stated in the above paragraph in which RFID technology has been implemented with the data processing through using FSM (Finite State Machine). The alliance with the RGHS provided an option for the researcher in manner to evaluate the efficiency and effectiveness of the presented technology (Sickbert et al., 2016). This technology helped in coping up with the limitations those have been identified in the previous technology and was proved to be reliable and also helpful in calculating the trends and probability of the compliance. Although, it can be stated as an important factor, the research presented a limited data of the rate of the compliances of the staffs working in the hospital system under the procedure of HH process that resulted in the low rate of the compliance.
Next article was chosen for raising the awareness of HH in different environments. Three systems have been proposed in this research paper, among which system 1 and system 2 have been proposed with same application design. The first system was composed of the data about the usage of antiseptic containers and number of the users, which have been transmitted wirelessly for the processing in the computer. The second system was composed of the data those have been transmitted and recorded via wired connection for the processing in the computer. Both the systems were evaluated on the activities recorded at the hospital and a universal cafeteria through the system 1 and 2 respectively. The need for the hand antiseptics was reported by most of the users and the numbers of users practicing the hand antiseptics were increased significantly. The third system was all about using AR technology after the evaluation of both the systems 1 and 2 (Asai et al., 2013). The research made in the paper was sufficient for revealing that most of the users do not recognize the importance of hand antiseptics in the environments those include public spaces such as public hall and other public places. The numbers of users practicing the hand antiseptics in an open environment are not more than the users, practicing the hand antiseptics in a closed environment.
Hugonnet, Perneger & Pittet, (2002) presented an article that presents an effective way for improving the compliance with the HH through alcohol-based handrub in intensive care units. The primary objective of this report was to present a measure that could be helpful in minimizing the rate of infection that has been spreading with higher rate within intensive care units. This report presents how such types of infection spreading rate could be minimized with the effective compliance of hand-hygiene within the care units. The research methodology was based on the seven surveys those have been implemented in the promotional campaign after putting base in the surgical, pediatric, and medical intensive care units (Chen et al., 2016). The main purpose was to measure the compliance of the hand-hygiene through hand-rubbing and hand-washing using alcohol. Based on the research and survey made by the authors, it can be reported that the intervention was helpful in inducing sustained and marked increase in the compliance with the hand hygiene through alcohol-based handrub and hand wash. The paper introduces how less-time consuming hand wash could be replaced in the intensive care units with the standard hand washing. This also introduces how it could be helpful in coping up with the time constraints.
Mahfouz, El Gamal & Al-Azraqi, (2013)presented a report with the purpose to measure the degree of the compliance with hand hygiene practices in the intensive care facilities among the health care workers at ACH (Aseer Central Hospital) that was located in south-western Saudi Arabia. It was introduced in the paper that proper education and training are the important objectives related to the compliance of hand hygiene within the hospitals or other clinic units. The purpose of the study was to determine the measurement of the degree of hand hygiene compliance in the intensive health care at Aseer Central Hospital (ACH) among the Health Care Workers (HCWs). It was being concluded by the authors that non-compliance with the guidelines related to the hand hygiene can be represented as a universal problem. Erasmus et al. (2010) reported that in manner to develop successful interventions, it is necessary to do a thorough research about the behavioral determinants of the non-compliance related to the hand hygiene. Based on the findings made by the researchers, it can be concluded that education related to the awareness program and training about hand hygiene can be used for the effective and efficient compliance of hand hygiene compliance within the intensive medical care facilities. ACH was the chosen case for the evaluation of the implementation that helped them in getting efficient results related to the compliance of hand hygiene within intensive medical care facilities.
Slamon et al. (2014) also shows their interest on the related topic and presented a research report on the compliance of hand hygiene among the HCWs in Vietnam hospitals. It was reported by the authors that washing hands with some antiseptics or soap is a general practice in the Vietnamese hospitals. This could be the best approach, if the tap water that is being supplied for such type of use were pure and clean. The risk of hand contamination has been introduced in the report and those have been compared with the efficacy of five common hygiene methods that was practiced within the tertiary Vietnamese hospitals (Samore & Harbarth, 2017). It was observed by the authors that HCWs were carrying various bacteria even without having direct contact with the patients, on their hand. Various steps have been stated in the report among which emphasis was put on the ABHR that could be helpful in overcoming the effects of high bacterial quantity in the contaminated water while indicating the hand-wash using water and soap.
Another article that has been proposed for this research put emphasis on the research made at eight hospitals in the United States with specific concentration on the causes of Noncompliance. In this research paper presented by Chassin, Mayer and Nether (2015), eight hospitals were chosen for the research on the compliance of hand hygiene within medical areas and attempt was made to introduce the left factors those were hidden in previous researches. The chosen eight hospitals together used Six Sigma, change management, and lean methods in manner to make the measurement of the noncompliance of hand hygiene within those hospitals. The authors also presented the causes that were main reasons behind lack of efficiency in compliance of HH. In manner to sustain enhanced level of performance test interventions have also been proposed in this report that could be helpful in assessing the major causes (Deyneko, 2016). Various methodologies have been used in manner to identify the root of the spread of diseases and based on that it was proposed that noncompliance of the hand hygiene is due to the improper monitoring and not using appropriate antibiotics for the preventions. Based on these activities qualitative data had been proposed that helped in learning that hand hygiene is a concerning topic and proper education and training is needed in manner to improve the compliance of hand hygiene within the hospitals.
Next article is based on the targeting globally the compliance of hand hygiene and improving the hand hygiene practices. Allegendry et al. (2012) spent a long time in researching the practices related to the compliance of hand hygiene in the world wide. They have expressed “compliance as the proportion of predefined opportunities met by hand-hygiene actions (i.e., hand washing or hand rubbing).” WHO made the vast donation in manner to make the research possible and researchers were able to make the findings. This research helped in understanding that it can be put on the top most concern of the global issues and should be given concern in manner to enhance the safety of the patients (Shen et al., 2017). Even using soap and antiseptics does not eliminate the possibilities of infection to the patients or the care workers who are involved in the medical section. Despite of direct contact there are many mediums through which bacteria can be spread to the individuals related to the hospitals or any other medical care’s including patients, nurses, and doctors. However, proper education, practices, training and monitoring could be helpful in overcoming such sort of issues. This was also reported in this paper that after the awareness program the rate of compliance of hand hygiene was improved.
Uneka et al. (2014) also presented their concern related to the hand hygiene compliance and presented a research in Nigerian hospital. They presented an example how safety practices provided through training and education could be helpful in enhancing the compliance of hand hygiene within the intensive health care’s. It is very important that the efficiency of compliance of hand hygiene is much high in manner to guarantee safety for the patients. This research presented the positive results of the practices made by the WHO hand hygiene guidelines. Teaching hospitals were chosen for the research in manner to find the root cause of such less efficiency. Based on the findings and research, authors concluded that compliance of hand hygiene could be enhanced and practiced in effective manner through using the tools and guidelines presented by WHO hand hygiene program. It can also be said that practicing hand hygiene methodologies introduced by WHO could be helpful in ensuring proper safety for the patients and the care workers with low-income expenditure.
The most recent article related to the topic was presented by Mert and Reza (2017), that presents a monitoring system on the compliance of hand hygiene that was based on internet of things (latest and much advanced technology). This paper presents a system prototype of stations for the hand hygiene stations those have been based on IoT (Internet of Things) and WSN (Wireless Sensor Network) technologies in manner to monitor the rate of compliance of hand hygiene. This is much advanced monitoring system with cloud implementation, completely different from the monitoring systems presented in the above report. This system could be helpful in ensuring the enhancement of hand hygiene compliance rate with proper monitoring and alarming system (Hwang, Kim & Rho, 2016). Before presenting it to the world, various tests and evaluation had been already made on the efficiency of the system and resulted in the boon for the medical sectors.
Conclusion
Based on the above report it can be concluded that compliance of hand hygiene is a concerning topic for the medical sectors as till now efficiency has not been reached to 100%. All the ten articles presented on the above report have different topics related to the hand hygiene compliance however; ultimate goal for each author was to make hospitals free from any of the infections that could be spread by such small negligence. Monitoring can be a better approach as stated in most of the papers. All the paper suggests that proper education and training are the best measures that could ensure the compliance of hand hygiene with complete efficiency. Despite of transparent result, it can be stated that all the authors were lack in describing all the factors and presented research findings without the factor of environmental spreading. On the other hand every research was focusing on the safety of the patients only however, it can be stated that a healthy person might also get infected through those bacteria and should also be given consideration. Every researchers were either focusing on the monitoring or practices, it can be recommended that indulging both the topics in a single research could result in effective and efficient compliance of hand hygiene within the intensive health care facilities.
References:
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